Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD443453 | PA |
NPI | 1174730113 |
---|---|
Provider Name | Benjamin Lewis Laskin |
First Address | Philadelphia, PA 19107-3377 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 11/02/2016 |